Introduction

Uses for Tetracaine

Ophthalmic Anesthesia

Applied topically to the eye to produce local anesthesia for diagnostic and therapeutic procedures (e.g., tonometry, gonioscopy, removal of foreign bodies or sutures from the cornea, conjunctival and corneal scraping for diagnostic purposes, paracentesis of the anterior chamber, thorough examination and irrigation of painful injuries, short procedures involving the cornea and conjunctiva).abc

Rhinolaryngeal Anesthesia

Tetracaine Dosage and Administration

Administration

Apply topically to the eye as a 0.5% ophthalmic solution.abc Apply directly to larynx, trachea, or esophagus as a 0.25 or 0.5% topical solution, or administer via oral inhalation as a nebulized 0.5% solution.ab

Do not use if solution contains crystals or is cloudy or discolored.abc

Ophthalmic Administration

Apply 0.5% ophthalmic solution topically to eye.ac For topical anesthesia only;b do not inject.c Not for self-medication.b

May add epinephrine 0.1% to produce vascular constriction when necessary.b

Cautions for Tetracaine

Contraindications

Known hypersensitivity to tetracaine or other local anesthetics of the ester type, to p-aminobenzoic acid or its derivatives, or to any ingredient in the formulation.abc

Self-administration of ophthalmic solution by patients without clinician supervision.c

Warnings/Precautions

Warnings

Systemic Toxicity

Rarely, use of local anesthetics causes reactions resulting in death.b When a local anesthetic is used (e.g., tetracaine for rhinolaryngeal anesthesia), ensure immediate availability of resuscitative equipment and drugs.b Excessive doses or rapid absorption may produce serious or fatal reactions.b (See Administration and also Prescribing Limits under Dosage and Administration).

Potential for life-threatening adverse effects (e.g., irregular heart beat, seizures, breathing difficulties, coma, death) when topical local anesthetics are applied to a large area of skin, when the area of application is covered with an occlusive dressing, if a large amount of topical anesthetic is applied, if the anesthetic is applied to irritated or broken skin, or if the skin temperature increases (from exercise or use of a heating pad).101102

Lidocaine 4% gel has been investigated to reduce discomfort during mammography.101103 Whether such use could result in serious reactions has not been determined.101103 Patients should speak with their clinician if they are considering using a topical anesthetic before obtaining a mammogram.101

When a topical anesthetic is needed for a procedure, use of an FDA-approved preparation has been recommended.k Use a preparation containing the lowest concentration of anesthetic likely to be effective; apply a small amount of the preparation to the affected area for the shortest period necessary for the desired effect,k and do not apply to broken or irritated skin.101